Number of prior episodes and the presence of depressive symptoms are associated with longer length of stay for patients with acute manic episodes

Background: Few studies have analyzed predictors of length of stay (LOS) in patients admitted due to acute bipolar manic episodes. The purpose of the present study was to estimate LOS and to determine the potential sociodemographic and clinical risk factors associated with a longer hospitalization. Such information could be useful to identify those patients at high risk for long LOS and to allocate them to special treatments, with the aim of optimizing their hospital management. Methods: This was a cross-sectional study recruiting adult patients with a diagnosis of bipolar disorder (Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DSM-IV-TR) criteria) who had been hospitalized due to an acute manic episode with a Young Mania Rating Scale total score greater than 20. Bivariate correlational and multiple linear regression analyses were performed to identify independent predictors of LOS. Results: A total of 235 patients from 44 centers were included in the study. The only factors that were significantly associated to LOS in the regression model were the number of previous episodes and the Montgomery-Åsberg Depression Rating Scale (MADRS) total score at admission (P < 0.05). Conclusions: Patients with a high number of previous episodes and those with depressive symptoms during mania are more likely to stay longer in hospital. Patients with severe depressive symptoms may have a more severe or treatment-resistant course of the acute bipolar manic episode.

Why are we fat? Discussions on the socioeconomic dimensions and responses to obesity

This paper draws together contributions to a scientific table discussion on obesity at the European Science Open Forum 2008 which took place in Barcelona, Spain. Socioeconomic dimensions of global obesity, including those factors promoting it, those surrounding the social perceptions of obesity and those related to integral public health solutions, are discussed. It argues that although scientific accounts of obesity point to large-scale changes in dietary and physical environments, media representations of obesity, which context public policy, pre-eminently follow individualistic models of explanation. While the debate at the forum brought together a diversity of views, all the contributors agreed that this was a global issue requiring an equally global response. Furthermore, an integrated ecological model of obesity proposes that to be effective, policy will need to address not only human health but also planetary health, and that therefore, public health and environmental policies coincide.

SYSTEMATICS OF GROUNDWATER OLIGOCHAETES (ANNELIDA, CLITELLATA) IN KARSTIC AREAS OF THE CANTABRIAN REGION/ ERREGIO KANTAURIARREKO EREMU KARSTIKOETAN DAUDEN LURPEKO OLIGOKETO (ANNELIDA, CLITELLATA) URT

This thesis deals with the oligochaete taxa (Annelida, Clitellata) from several karst units in the Cantabrian region, northern Iberian Peninsula. Groundwater oligochaetes are still poorly known fauna and the area seems to be a promising hotspot for groundwater taxa. Metodology is based on both morphological and molecular analyses. More than 7,000 specimens were collected from five karst units and >60 taxa were identified. Stygobiont oligochaete fauna in the northern Iberian Peninsula is diverse and mostly endemic (range areas <300 km). Three new stygogiont oligochaete species are described: Gianius navarroi Rodriguez & Achurra, 2010, Isochaetides gianii Rodriguez & Achurra, 2010 and Troglodrilus jugeti Achurra et al., 2012; and another four new taxa will be described in the near future. Taxonomic remarks on Lophochaeta ignota Stolc, 1886 and Troglodrilus galarzai (Giani & Rodriguez, 1988) are provided. The controversial separation of L. ignota and Heterochaeta costata Claparède, 1863 from Tubifex Lamarck, 1816 is corroborated by mitochondrial molecular data. Following the DNA barcoding method, individuals of the stygoxene species Stylodrilus heringianus Claparède, 1862 from different geographic areas are shown to represent a single metapopulation. The first phylogenetic analysis of the subfamily Tubificinae based on molecular data is attemped, which although incompletely resolved, evidences for the first time a close relationship between a stygobiont oligochaete (Troglodrilus Juget et al. 2006) and an estuarine especies (Heterochaeta costata Claparéde, 1863). A marine ancestor is hypothesised for Troglodrilus. Finally, Ereñozar karst unit (Biscay) is suggested to be a hotspot for groundwater oligochaetes (11 stygobiont taxa, of which 4 are endemic to the karst unit) and several biodiversity indices (Species richness, Rarity, Vulnerability and Complementarity) are shown to be useful tools for conservation management of groundwater habitats in that karst area.